Organization
LAFAYETTE CHIROPRACTIC LLC
Active
Other names
Wagner Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ALAN BOWMAN DC (OWNER)
(765) 448-1674
Entity
Organization
Contact information
Practice address
3778 UNION ST, LAFAYETTE, IN 47905-4453
(765) 448-1674
(765) 449-0847
Mailing address
3778 UNION ST, LAFAYETTE, IN 47905-4453
(765) 448-1674
(765) 449-0847
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200925750 A
—
IN
01
—
256900
MEDICARE PTAN
IN
Enumeration date
02/28/2008
Last updated
10/25/2022
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